When you think of the kind of people who need donated sperm to have a child, do soldiers returning from war come to mind?

Like all soldiers on active service, Sergeant Rick Clements was briefed by the army about the possibility of losing limbs in Afghanistan. The possibility of losing his fertility was never raised. When an IED bomb blast in Helmand a year ago left him without his legs, it was a double blow to discover he could never father a child with his fiancee.

Now he thinks that all soldiers should be offered free treatment to freeze their sperm to protect their fertility.

“The Ministry of Defence is doing brilliant work warning soldiers about the dangers of losing limbs at war. But there is no warning that fighting could leave you unable to have children. No one wants to talk about losing your testicles – it’s a highly emotive subject.”Rick Clements

The prevalence of IEDs in Afghanistan means it’s becoming more common for soldiers to receive serious injuries to the legs and groin. Military couples are taking advantage of new technology to store sperm before going on active service to ensure they can still have a family should the worst happen. But sperm storage is expensive, and for some it’s already too late.

Surely when someone has sacrificed so much, they deserve a bit of help to get their life back on track now they’re home.

Using donors from the US adds complication to an already complex process. First, there’s the issue of ‘egg miles’. Eggs would need to be frozen due to the time and distance they need to travel, meaning fresh transfers aren’t possible. Despite how far technology has come in the last few years, pregnancy rates from frozen eggs or embryos are still not as high as pregnancy rates from fresh embryos.

Then there’s the issue of recruiting donors in a country where vast amounts of money are paid to donors for their eggs. To donate to British couples, donors would have to abide by UK law and accept no more than £250 in reimbursement for loss of earnings.

Looking to the future, it’s also important to recognise how much harder it might be for a donor-conceived person to trace a biological parent who lives outside the UK.

It must have cost a large sum of money to set up and run these trials. Given this, and the greater success rates from treatment with fresh eggs ‘sourced locally’, how many home-grown donors could have been recruited in the UK if the money had been spent on advertising and donor care instead?

As a headline issue in the recent HFEA consultation, payment of donors is high on the agenda. But there’s one payment-related issue some clinics could sort out that would make life easier for donors: paying expenses during treatment.

Donors have to attend clinics a number of times before their treatment starts, for tests and counselling. During treatment, egg donors attend at least seven times and sperm donors more than that, as their donation cycle lasts much longer. Some clinics will only pay travel and other expenses when the donation cycle is over. But this leaves the donor to cover their own travel and any other expenses, such as childcare, out of their own pocket until they’re reimbursed later.

Clearly, donors who are less well off are disadvantaged more by this. And they’re proportionately more likely to be people in their 20s with children – exactly the kind of people who would make perfect donors.

Some clinics understand that paying expenses in a lump sum at the end of the donation, while it’s easier for them to administer, makes life harder for their donors. But for those who continue to do this, where the smooth running of the clinic is prioritised over the donor experience, you have to ask whether those priorities are really helping recruit the best donors.

Travelling to the clinic weekly (or more often) for up to three months

Travelling to the clinic about ten times over the course of a month

Keeping the quality of sperm donations high means you have to organise your sex life around the donation

Avoiding the risk of getting pregnant yourself means you have to organise your sex life around the donation

The embarrassment and performance anxiety of providing a sample on demand in the clinic

Egg collection is done via a surgical procedure at a hospital

Sorry lads, I can’t think of an equivalent for this but feel free to suggest one!

Injecting hormones, sometimes with ‘fun’ side effects

By the time your donation is used recipients have forgotten their donor is a real person

A nice thank you from the recipients

Everyone thinks you are a w**ker

Everyone thinks you are a saint

Of course, in the UK donors only get expenses rather than being paid hefty sums of money, but still, sperm donors do their bit towards getting a couple pregnant, yet seem to go unappreciated. The lads insist the disparity is because women moan more while they suffer in manly silence. What do you think?

Dr Ruth Curson answers your medical questions about egg and sperm donation. She recently retired from her job as Specialist at the Assisted Conception Unit, King’s College Hospital, London.

Dear Dr Ruth

I’ve been told my ovarian reserve is low (AMH=11). Does that mean I can’t be a donor? Also, I haven’t had children of my own yet – does it mean I can’t get pregnant either?

Anne

There are a lot of ideas and not a lot of certainties about low ovarian reserve. I would love someone to do the research project, which would have to involve a large number of women being tracked over probably 20 years to get any meaningful results. But at a time when no one has done this work, I shall just have to explain our hunches.Read the rest of this entry »

Have you ever wondered whether your donation of eggs or sperm could really make a difference to someone’s life? Ever thought that it seems like a lot of hassle to go through for someone you don’t know?

The Guardian recently ran a piece in their Letters you always wanted to write series, from a woman who had a child by sperm donation with her partner. Among many other touching words, she says:

To my son’s sperm donor, I mostly want to say thank you, and hope that the joy that you have brought to us is reflected in equal measure in your life.

The Trust is making a collection of letters like this to make into a book to give to donors. This is to help donors realise just how much of a positive impact their unselfish gift can make to another family. People don’t always realise they can send their donor a thank you letter via the clinic, so donors don’t always receive this simple acknowledgement from one person to another.

In an environment where donation is largely anonymous, it also acts as a reminder of the human story behind the statistics. Donors, recipients and donor-conceived children are all curious about each other.

Maybe he’ll come to look for you when he turns 18; maybe he won’t feel the need to. I like the fact that he has that choice… I like to think that if he does seek you out, you’ll be proud of the person you helped to create.

And if you’re reading this now and thinking, maybe it is worth the hassle, perhaps I could think again – thank you.

One of the highest-profile online newsletters covering assisted conception is celebrating 12 years and 600 issues of publication.

Bionews, published by Progress Educational Trust (PET), regularly features egg, sperm and embryo donation issues as well as news and views on genetics and stem cell research. Over the years it has published comment pieces from most of the best known figures in the field, including our own Laura Witjens, Chair of the National Gamete Donation Trust.

As well as Bionews, PET regularly organises conferences on assisted conception issues, bringing together people interested in donation from all perspectives (academic, clinicians, counsellors, charities, individual donors and recipients and many more).

We’d like to raise a toast to them for their hard work in keeping donation issues on the agenda, for keeping us all up to date with what’s going on, and for covering what can be controversial topics from all perspectives.

Marie Stopes International, a charity giving contraception and abortion advice, has been criticised for releasing a viral video with a safe sex message aimed at teenagers: ‘One up the bum and you won’t be a mum’.

Is being outrageous the most effective way to get people to listen to your message?

In 2007, the NGDT released a viral campaign to recruit sperm donors, raising awareness of the need for sperm donors in a direct and fun way. Called ‘Give a toss‘, it included video of a spoof news item about ‘National Sperm Day’ and a cheeky online game, the Toss-o-meter. It was designed to appeal to men who had never thought about infertility but who might ‘give a toss’ about couples who need donor sperm to have kids. The Give a toss campaign lasted for five months; over 500 people passed it on to their friends, and enquiries went up all over the country as a result.

At the time, some critics thought it was inappropriate to talk about sperm donation in a humorous way, and argued that joking about masturbation would make infertility patients and donor conceived adults feel belittled.

‘This tongue-in-cheek approach leads young people to a website with all the information and contact details they need to make informed lifestyle choices.’

From our own experience, we know it’s important to talk to donors in a way they can relate to. Different people have different needs: some respond well to sensitively-written text about how much recipients want a baby. Others, who perhaps who haven’t thought about it before, find earthy humour a more comfortable way to begin to talk about sperm donation.